A federal task force that gave prostate cancer screening a D grade -- as in don't screen men who have no symptoms of the disease -- should bump that rating to a C, an MD Anderson scientist argues this week in a commentary in the Journal of the American Medical Association.
A grade C more closely fits available clinical evidence and will encourage clinicians to engage men in informed decision-making, a process that the D grade is likely to preempt, Robert Volk, Ph.D., professor in General Internal Medicine, notes with co-author Andrew Wolf, M.D., of the University of Virginia.
The USPSTF reviews evidence from clinical research and then recommends a variety of grades for a service, ranging from A (recommended, with a high certainty that the net benefit is substantial) to D (recommends against the service because there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.)
Prostate cancer screening by testing for levels of the prostate-specific antigen currently has an I grade -- the current evidence is insufficient to assess the balance of benefits and harms of the service.
Based on trial results
Volk and Wolf note that the task force relied on the results of three randomized screening trials, which it rated as being of fair quality. Two of those three show a benefit of screening.